World federation of interventional and therapeutic neuroradiology (WFITN) federation assembly neurointerventional surgery safety checklist.

Over the last 10 years, there has been a rise in neurointerventional case complexity, device variety and physician distractions. Even among experienced physicians, this trend challenges our memory and concentration, making it more difficult to remember safety principles and their implications. Checklists are regarded by some as a redundant exercise that wastes time, or as an attack on physician autonomy. However, given the increasing case and disease complexity along with the number of distractions, it is even more important now to have a compelling reminder of safety principles that preserve habits that are susceptible to being overlooked because they seem mundane. Most hospitals have mandated a pre-procedure neurointerventional time-out checklist, but often it ends up being done in a cursory fashion for the primary purpose of 'checking off boxes'. There may be value in iterating the checklist to further emphasize safety and communication. The Federation Assembly of the World Federation of Interventional and Therapeutic Neuroradiology (WFITN) decided to construct a checklist for neurointerventional cases based on a review of the literature and insights from an expert panel.

Delayed massive epistaxis from traumatic cavernous carotid false aneurysms: A report of two unusual cases.

Introduction Blunt head trauma can injure the cavernous segment of the internal carotid artery (ICA). This may result in a carotid cavernous fistula (CCF). Rarely, a traumatic aneurysm may bleed medially causing massive epistaxis. Case presentation We present two cases of traumatic intracavernous carotid pseudoaneurysms with delayed massive epistaxis. The patients were managed with endovascular treatment involving coil embolization with parent vessel sparing and detachable balloon occlusion with carotid sacrifice. Early clinical outcome was good in both patients. Wherever possible, the CARE1 guidelines were followed in the reporting. Conclusion These cases illustrate the delayed nature of traumatic aneurysms and the need for a high index of suspicion in the presence of skull base fractures. The use of endovascular detachable balloon occlusion and coil embolization treatment with parent vessel preservation is shown.

Compound depressed skull fractures involving a venous sinus.

BACKGROUND: Neurosurgeons have always been wary about operating on compound depressed skull fractures overlying a venous sinus. Conservative treatment of such lesions, however, must be weighed against the benefits of surgery reducing sepsis, mass effect, and improving cosmetic appearance. There has been little published on this surgical problem and with this in mind, we undertook a review of the clinical features, management and outcome of patients presenting to our unit with a depressed fracture over a venous sinus. METHODS: A retrospective review of all patients presenting with a compound depressed skull fracture over a venous sinus from 1997 to 2000. Computer tomography scans and patient records were used. RESULTS: Of the 146 patients with depressed skull fractures, 27 (18%) were eligible. Of the 27 patients, 14 were treated conservatively and 13 were treated with surgery. Intra-operative difficulty was experienced in 6 (46%) of those taken to the operating room. Of those treated conservatively 14% developed sepsis. CONCLUSION: We feel that a more conservative approach to fractures involving a sinus is warranted. If the wound is not contaminated, the risk of infection is low. Surgery exposes the patient to the very real risk of massive hemorrhage. In instances where there is a clear need for surgery, such as the presence of mass effect or deep contamination, adequate precautions should be taken.

«Interventional Neuroradiology: a neuroscience sub-specialty?¼.

Interventional Neuroradiology (INR) is not bound by the classical limits of a specialty, and is not restricted by standard formats of teaching and education. Open and naturally linked towards neurosciences, INR has become a unique source of novel ideas for research, development and progress allowing new and improved approaches to challenging pathologies resulting in better anatomo-clinical results. Opening INR to Neurosciences is the best way to keep it alive and growing. Anchored in Neuroradiology, at the crossroad of neurosciences, INR will further participate to progress and innovation as it has often been in the past.

Editorial: «Interventional Neuroradiology: a Neuroscience sub-specialty?¼.

Interventional Neuroradiology (INR) is not bound by the classical limits of a speciality, and is not restricted by standard formats of teaching and education. Open and naturally linked towards neurosciences, INR has become a unique source of novel ideas for research, development and progress allowing new and improved approaches to challenging pathologies resulting in better anatomo-clinical results. Opening INR to Neurosciences is the best way to keep it alive and growing. Anchored in Neuroradiology, at the crossroad of neurosciences, INR will further participate to progress and innovation as it has often been in the past.